1. It is estimated that the following percentage of people that incur costs for health care do not receive what they are entitled to.

Transcription

1 1. It is estimated that the following percentage of people that incur costs for health care do not receive what they are entitled to. a. 40% b. 50% c. 60% d. 70% 2. Which of the following types of policies is responsible for paying a claim first? a. The supplementary policy. b. The primary policy c. The secondary policy d. The major medical policy 3. If you are over age 65, Medicare eligible, work full-time and are covered under your employers group plan, which of the following statements is TRUE regarding payment of a claim? a. Medicare is primary. b. The company s group plan is secondary. c. The company s group plan is primary & Medicare is secondary. d. Claim payment is delayed six months. 4. Which of the following is a simple & easy way to confirm your health coverage? a. Call the underwriting department b. Call your doctor c. Call the Insurance Commissioner d. Call the claims department. 5. Which one of the following is a very important consideration made by the insurance company when computing deductibles? a. Reasonable charges. b. Reasonable and Customary charges. c. Customary charges d. Your age. 6. Regarding medical bills that are due, who is the responsible party? a. The insurance carrier b. The hospital c. The insured d. The doctor 7. Before sending any documentation to the insurance company, such as bill receipts and claim forms, you should ALWAYS do one of the following: a. Call the company first b. Contact your agent 1

2 c. Use certified mail d. Make copies of everything 8. Basically, there are four reasons that a Medicare claim can be denied or underpaid. Which one of the following IS NOT one of the four? a. Not filing your claim within 2 days. b. Errors caused by omission of information. c. Insurance coverage disputes. d. Errors made by clerical personnel. 9. Which one of the following represents the RANGE of cost per year for a Long-Term Care facility? a. $35,000 to $45,000 b. $30,000 to $37,000 c. $25,000 to $52,000 d. $45,000to $50, The AVERAGE length of time a person stays in a Long Term Care Facility is: a. 357 days b. Unknown c. 502 days d. 456 days 11. By the year 2050, it is estimated that the age 100 population will be: a. 1 million b. 750,000 c. 500,000 d. 2 million 12. Which of the following IS NOT considered one of the common Long-Term Care policy benefits? a. Skilled nursing care b. Wheelchair care c. Intermediate care d. Custodial Care 13. Patients can be given assistance with their Activities for Daily Living also known as ADL s. Which one of the following is considered to be an ADL? a. Grocery shopping b. Picking up cleaning c. Driving an auto d. Personal Hygiene 14. Long Term Care policies contain certain exclusions. Which one of the following IS NOT one of them? 2

3 a. Care provided by a family member b. War c. Losses covered by Workers Compensation d. Self inflicted injuries 15. The underwriting process employs four important sources of information. Which ONE of the following IS one of the four? a. The doctor b. The agent c. The hospital d. The X-ray technician 16. The uniform policy provision law established how many total policy provisions? a. 12 b. 32 c. 23 d How many of the Uniform Policy Provisions are REQUIRED and must appear in all health policies? a. 12 b. 32 c. 11 d Within how many days do you have to give a carrier Notice of Claim? a. 10 days or as reasonably possible b. 20 days or as reasonably possible c. 10 days d. 20 days 19. In the event a claim is paid while a premium that is due remains unpaid which one of the following applies? a. The claim will be denied. b. You must pay the premium within 10 days. c. The premium due will be subtracted from the claim due. d. No action will be taken on the claim. 20. How many days written notice must a company give in order to cancel a health policy? a. 10 days b. 15 days c. 17 days d. 20 days 3

4 21. Long Term Care policies will soon contain NON-FORFEITURE options. Which ONE of the following IS NOT a non-forfeiture provision? a. Cash value b. Return of all premiums c. Extended Term d. Reduced Paid Up 22. Which ONE of the following statements applies to what was said about Americans and their paychecks: a. Americans save every 4 th paycheck. b. Americans get paid every other week. c. 97 out of 100 Americans would be bankrupt if they missed 3 paychecks. d. Americans get paid once a month. 23. Disability Income Plans contain elimination or waiting periods. Which ONE of the following IS NOT a common elimination period? a. 365 days b. 90 days c. 30 days d. 17 days 24. The benefit period is the length of time you can expect to receive monthly disability payments. Which ONE of the following IS a common benefit period? a. 2 years b. 1 ½ years c. 6 years d. 10 years 25. Non-Cancelable disability policies provide some important guarantees regarding what the company CANNOT do. There are how many in all? a. 9 b. 7 c. 5 d There are 4 basic definitions of occupations. Which ONE of the following IS NOT one of the four? a. Regular occupation b. Non-Occupation c. Limited regular occupation d. Permanent occupation 4

5 27. Disability Income plans offers many optional benefits that can customize the policy. Which ONE of the following IS an optional benefit? a. Social Security rider. b. Outpatient rider. c. Reduction of benefit. d. Increased Premiums Option. 28. Overhead Expense policies WILL NOT pay benefits for certain losses. Which ONE of the following WOULD NOT be paid? a. Rent. b. Salaries, draws, commissions of owner. c. Postage. d. Telephone. 29. Often a key person becomes sick or hurt and causes severe financial consequences to the company. Which of the following policies would be a good solution to protect the company? a. Major medical protection b. Group term life insurance c. A supplemental hospital plan d. Key employee disability income 30. Medical underwriting on Disability income is done two ways. Which ONE of the following IS correct? a. In the field with the agent and questions on the application b. With the doctor and underwriter. c. With the agent and hospital. d. With the hospital and doctor 5